Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator ' ° o <br /> APPLICATION FOR LAND USE PERMITS 3. 6 <br /> a W w <br /> � C <br /> OWNER S4t i1 R L �J, n ' 1 TELEPHONE Ile `l J <br /> � O <br /> HOME ADDRESS y ns— 'e lc� m Rl 560A� r 9 <br /> o <br /> EMERGENCY/FIRE NUMBER ROAD NAME /t1 e, v V <br /> r <br /> LEGAL DESCRIPTION(see tax receipt) 7 w <br /> L c r I d M l✓c c ! l'6 3 See �.f %Y e i✓ /d l*i W <br /> r 0 <br /> G7 <br /> 0 <br /> TYPE OF PERMIT(S):DWELLING/BUILDING -W� GARAGE/ACCESSORY STRUCTURE 4 /ADDITION ✓ ) n o <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION y v(}I <br /> m <br /> 7 <br /> STRUCTURE/ADDITIO S <br /> e/Cabin;Commercial Business;Bedroom;Deck;etc.) I <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR n 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. j E o l' ^ r ry f K M <br /> w <br /> DIRECTIONS FOPLAW <br /> OT PLAN DRAWING: (AERIAL OR TOP VIEW) (/ I t /a FR E eu s <br /> q �Li <Af3=.v N <br /> R <br /> CL <br /> 71 ^ ` z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m :b <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE y .. I c <br /> NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m v <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, c <br /> STREAM OR RIVER. <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- <br /> INGS,ROADS,LAKE,LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. c 1 <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER,BUILDER,CONTRACTOR,ETC.,THE PLANS 0, c <br /> MUST BE SIGNED AND DATED BY THE OWNER. to <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE g S <br /> ISSUED. <br /> z O <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN 75 FEET OF THE OHWM OF LAKES, <br /> PONDS,RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. n �1 r0ms <br /> pCLO <br /> 5V C MS <br /> 6. ` CID <br /> z : CDQ <br /> Hol <br /> 7. =w s m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of n E <br /> application(including an accompanyingschedule)and I further declare that I recognize m o m <br /> all Information contained in this app (� 9 Y <br /> that this information I am providing will be relied upon by the County of Bumeft Wisconsin in determining whether to Is m <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this inforrnation I am i m <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other m i <br /> authorized person to have access to the above described premises at any reasonable tirose of Inspection. <br /> SIGN HERE � � • <br /> (signature of owner or building contractor) (date) i <br /> f`J(� I JUN 7 .5 <br /> ZONING ADMINISTRATOR h <br /> q(p fgNHH9 <br /> •.,� �OtNJ1N OO <br /> 0 0 0 0 0 0 0 <br /> TOWNSHIP PERMITS MAY BE REQUIRED _ 0 0 0 0 0 0 0 <br /> 1' <br />